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APPLICATIC _J FOR CONSTRUC7� JN <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />PERMIT � <br />BUILDING DEPARTMENT/ L HEATWG S`fSTEA4: U GAS f� ELECTRIC ❑ <br />259-8810 �� IIbf711u%LSi- L P �i/5il . <br />`Y `t <br />I! DEMOLITION I i COMBINATION BUILDING � i MECHANICAL ! PLUMBING <br />OWNER M,11L A�DRE55 CIiY ZIP PHONE <br />SIGN <br />'�' MAILl.DDRESS CIN ?IP PHONE <br />(�jo57p1.1 Gf-jickctiJ �F ' IIC�� pVE 5E EVERET7 9fr2o3 <br />ARCHIT:CTOR�ESIGNER h1A1LA00RE55 CITV ZIP PNONE <br />Gc�r.T RAcZfJ2 <br />GEhER�LCONTRpCTOR MNLAOORESS CITY ZIP PHONE STATGLICENSEn <br />MEK-RZ� 2�9! <br />—�Y�R �t�.�< <n. Ir1C Oo 60>( 3'���I SC–AYT! 9k/33 –''�7y'S (2�i �lZ4i ,ia YF,t�• y�i <br />MECHANICALCGNTRACTOR NAI�AU�RE55 CITY 21f PHONE STATELIGENSE9 <br />—ol JQ <br />PLUbI81NGCONTRACTOR AIAI�A�DRESS CITV ZIP PHONE Si�TELICENSEn <br />J/�NEW i_! ADDITION <br />CONTqqCTPRIC[OFWORK � <br />DESLRIBE WORK AND SOUARE F( <br />•�� � 1�vf Tf= U \ <br />PROPOSED USE OF 6UILDING <br />IEGAL OESCRIPTION OF PROPER' <br />LOT BLOCN _ <br />SEE A�-cA .cEIE <br />PRQiECT <br />PLUMBING <br />I 1 ALTERATION <br />�g� n�G`� <br />� <br />�GEINVOLVED <br />17.3�� <br />IHOWG �ELOW OR ARACH <br />_ OF � <br />� � <br />S�� <br />h��L� <br />7YPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOVJER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />UHINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK <br />'��. i REPAIR ! i DEMOLITION '�� '� WOODSTOVE/FRPL INSERT <br />I CONTACT PERSON AND PHONE N0. <br />C�� <br />FEE <br />c <br />SUB TOTAL $ ' <br />PERMIT $ <br />� TOTAL FEE S ' <br />FOR OFFICE USE ONLY: <br />FFONi SETBACIS REAR SETBACK SI�E SETBACK <br />/ D' <br />USEZONE AREA VACANTSITE <br />C - � �S� <br />iYPEOiCONiS.ALLOIYABLc ttPEOFCONSLACTUAI aCN:u�tv IiOo�OwFwNcunrtS <br />� GPOUP <br />SIZE OF BLOG. <br />OCCUPANCYLOAO <br />REASON FOB SPRII <br />INTAKE BY <br />NO. OF STORIES <br />FIFE SPflNNIEflS REO'D <br />PLANS APPROVED �Y <br />HEIGHi UlAITATIOfI 6/ <br />/ � � r7N <br />rax ccoe is <br />I BUILDING RELOCATION <br />i HEREBY CERTIFY THAT I HAVE READ AND EY.AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AlJD CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AD'v <br />OTHER STATE GR LOCAL LAW REGULATING CONSTRUCTION OR TNE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TIiE <br />OWNER OF THIS PROPEFiTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 CCIMPLY WITH THE STATE <br />CONTRACTORS LAVJ 18.27 RCW AND 296.200 WAC. <br />X/_�.� � ra I 0�, �/,� �9s <br />SIG�IdTpRE —��C pJE <br />TYPE OF EOUIPMENT <br />A/C—A/HNDLG UNITS—H P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />GAS PIPING <br />EXHAUSTFAN <br />PLAN <br />BUILDING <br />PLUMBIIIG <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />SPRINKLER <br />STATE 9UILOING SURCHAFGE <br />F'UBLIC WORKS <br />TCTi1�_ <br />SUB TOTAL 5 <br />PERMIT 3 <br />TOTALFEE ,5 <br />RECEIPT NO. <br />��i��v <br />� FEE <br />� <br />/,�9: - <br />I <br />i <br />i <br />i <br />-�— <br />i <br />i <br />� <br />i �—/. <br />i � <br />� <br />� <br />T <br />